QI-Core Implementation Guide
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QI-Core Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 7.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-qi-core/ and changes regularly. See the Directory of published versions

Resource Profile: QICoreImagingStudy - Detailed Descriptions

Active as of 2018-08-22

Definitions for the qicore-imagingstudy resource profile.

Guidance on how to interpret the contents of this table can be found here

0. ImagingStudy
2. ImagingStudy.subject
Short(QI) Who or what is the subject of the study
TypeReference(QICore Patient)
4. ImagingStudy.encounter
Definition

The healthcare event (e.g. a patient and healthcare provider interaction) during which this ImagingStudy is made.

ShortEncounter with which this imaging study is associated
Comments

This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission test).

Control0..1
TypeReference(QICore Encounter)
Is Modifierfalse
6. ImagingStudy.started
Short(QI) When the study was started
8. ImagingStudy.basedOn
Short(QI) Request fulfilled
TypeReference(QICore ServiceRequest, QICore CarePlan)
10. ImagingStudy.referrer
TypeReference(QICore Practitioner, QICore PractitionerRole)
Must Supportfalse
12. ImagingStudy.interpreter
TypeReference(QICore Practitioner, QICore PractitionerRole)
Must Supportfalse
14. ImagingStudy.procedureReference
Short(QI) The performed Procedure reference
TypeReference(QICore Procedure)
16. ImagingStudy.location
Definition

The principal physical location where the ImagingStudy was performed.

ShortWhere ImagingStudy occurred
Control0..1
TypeReference(QICore Location)
Is Modifierfalse
Requirements

Ties the event to where the records are likely kept and provides context around the event occurrence (e.g. if it occurred inside or outside a dedicated healthcare setting).

18. ImagingStudy.reasonReference
Definition

Indicates another resource whose existence justifies this Study.

ShortWhy was study performed
Control0..*
TypeReference(QICore Condition Problems Health Concerns, QICore Simple Observation, Media, QICore DiagnosticReport Profile for Report and Note Exchange, DocumentReference)
Is Modifierfalse
20. ImagingStudy.series
22. ImagingStudy.series.performer
24. ImagingStudy.series.performer.actor
Definition

Indicates who or what performed the series.

ShortWho performed the series
Control1..1
TypeReference(QICore Practitioner, QICore PractitionerRole, QICore Organization, QICore CareTeam, QICore Patient, QICore Device, US Core Implantable Device Profile, QICore RelatedPerson)
Is Modifierfalse

Guidance on how to interpret the contents of this table can be found here

0. ImagingStudy
Definition

Representation of the content produced in a DICOM imaging study. A study comprises a set of series, each of which includes a set of Service-Object Pair Instances (SOP Instances - images or other data) acquired or produced in a common context. A series is of only one modality (e.g. X-ray, CT, MR, ultrasound), but a study may have multiple series of different modalities.

ShortA set of images produced in single study (one or more series of references images)
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. ImagingStudy.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. ImagingStudy.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. ImagingStudy.status
Definition

The current state of the ImagingStudy.

Shortregistered | available | cancelled | entered-in-error | unknown
Comments

Unknown does not represent "other" - one of the defined statuses must apply. Unknown is used when the authoring system is not sure what the current status is.

Control1..1
BindingThe codes SHALL be taken from ImagingStudyStatushttp://hl7.org/fhir/ValueSet/imagingstudy-status|4.0.1
(required to http://hl7.org/fhir/ValueSet/imagingstudy-status|4.0.1)

The status of the ImagingStudy.

Typecode
Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. ImagingStudy.subject
Definition

The subject, typically a patient, of the imaging study.

Short(QI) Who or what is the subject of the studyWho or what is the subject of the study
Comments

QA phantoms can be recorded with a Device; multiple subjects (such as mice) can be recorded with a Group.

Control1..1
TypeReference(QICore Patient, Patient, Device, Group)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. ImagingStudy.encounter
Definition

The healthcare event (e.g. a patient and healthcare provider interaction) during which this ImagingStudy is made.

ShortEncounter with which this imaging study is associated
Comments

This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission test).

Control0..1
TypeReference(QICore Encounter, Encounter)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. ImagingStudy.started
Definition

Date and time the study started.

Short(QI) When the study was startedWhen the study was started
Control0..1
TypedateTime
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Alternate NamesStudyDate, StudyTime
Example<br/><b>General</b>:2011-01-01T11:01:20+03:00
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. ImagingStudy.basedOn
Definition

A list of the diagnostic requests that resulted in this imaging study being performed.

Short(QI) Request fulfilledRequest fulfilled
Control0..*
TypeReference(QICore ServiceRequest, QICore CarePlan, CarePlan, ServiceRequest, Appointment, AppointmentResponse, Task)
Is Modifierfalse
Summarytrue
Requirements

To support grouped procedures (one imaging study supporting multiple ordered procedures, e.g. chest/abdomen/pelvis CT).

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. ImagingStudy.referrer
Definition

The requesting/referring physician.

ShortReferring physician
Control0..1
TypeReference(QICore Practitioner, QICore PractitionerRole, Practitioner, PractitionerRole)
Is Modifierfalse
Must Supportfalse
Summarytrue
Alternate NamesReferringPhysiciansName
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. ImagingStudy.interpreter
Definition

Who read the study and interpreted the images or other content.

ShortWho interpreted images
Control0..*
TypeReference(QICore Practitioner, QICore PractitionerRole, Practitioner, PractitionerRole)
Is Modifierfalse
Must Supportfalse
Summarytrue
Alternate NamesName of Physician(s) Reading Study
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. ImagingStudy.procedureReference
Definition

The procedure which this ImagingStudy was part of.

Short(QI) The performed Procedure referenceThe performed Procedure reference
Control0..1
TypeReference(QICore Procedure, Procedure)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. ImagingStudy.location
Definition

The principal physical location where the ImagingStudy was performed.

ShortWhere ImagingStudy occurred
Control0..1
TypeReference(QICore Location, Location)
Is Modifierfalse
Summarytrue
Requirements

Ties the event to where the records are likely kept and provides context around the event occurrence (e.g. if it occurred inside or outside a dedicated healthcare setting).

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. ImagingStudy.reasonReference
Definition

Indicates another resource whose existence justifies this Study.

ShortWhy was study performed
Control0..*
TypeReference(QICore Condition Problems Health Concerns, QICore Simple Observation, Media, QICore DiagnosticReport Profile for Report and Note Exchange, DocumentReference, Condition, Observation, DiagnosticReport)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

Guidance on how to interpret the contents of this table can be found here

0. ImagingStudy
Definition

Representation of the content produced in a DICOM imaging study. A study comprises a set of series, each of which includes a set of Service-Object Pair Instances (SOP Instances - images or other data) acquired or produced in a common context. A series is of only one modality (e.g. X-ray, CT, MR, ultrasound), but a study may have multiple series of different modalities.

ShortA set of images produced in single study (one or more series of references images)
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. ImagingStudy.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

ShortLogical id of this artifact
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Control0..1
Typeid
Is Modifierfalse
Summarytrue
4. ImagingStudy.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

ShortMetadata about the resource
Control0..1
TypeMeta
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. ImagingStudy.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. ImagingStudy.language
Definition

The base language in which the resource is written.

ShortLanguage of the resource content
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Control0..1
BindingThe codes SHOULD be taken from CommonLanguages
(preferred to http://hl7.org/fhir/ValueSet/languages)

A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. ImagingStudy.text
Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

ShortText summary of the resource, for human interpretation
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Control0..1
TypeNarrative
Is Modifierfalse
Summaryfalse
Alternate Namesnarrative, html, xhtml, display
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. ImagingStudy.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

ShortContained, inline Resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Control0..*
TypeResource
Is Modifierfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
14. ImagingStudy.extension
Definition

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
16. ImagingStudy.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
18. ImagingStudy.identifier
Definition

Identifiers for the ImagingStudy such as DICOM Study Instance UID, and Accession Number.

ShortIdentifiers for the whole study
Comments

See discussion under Imaging Study Implementation Notes for encoding of DICOM Study Instance UID. Accession Number should use ACSN Identifier type.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Is Modifierfalse
Summarytrue
Requirements

If one or more series elements are present in the ImagingStudy, then there shall be one DICOM Study UID identifier (see DICOM PS 3.3 C.7.2.

Alternate NamesStudyInstanceUID, AccessionNumber
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. ImagingStudy.status
Definition

The current state of the ImagingStudy.

Shortregistered | available | cancelled | entered-in-error | unknown
Comments

Unknown does not represent "other" - one of the defined statuses must apply. Unknown is used when the authoring system is not sure what the current status is.

Control1..1
BindingThe codes SHALL be taken from ImagingStudyStatus
(required to http://hl7.org/fhir/ValueSet/imagingstudy-status|4.0.1)

The status of the ImagingStudy.

Typecode
Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. ImagingStudy.modality
Definition

A list of all the series.modality values that are actual acquisition modalities, i.e. those in the DICOM Context Group 29 (value set OID 1.2.840.10008.6.1.19).

ShortAll series modality if actual acquisition modalities
Control0..*
BindingUnless not suitable, these codes SHALL be taken from AcquisitionModality
(extensible to http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html)

Type of acquired data in the instance.

TypeCoding
Is Modifierfalse
Summarytrue
Alternate NamesModalitiesInStudy
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. ImagingStudy.subject
Definition

The subject, typically a patient, of the imaging study.

Short(QI) Who or what is the subject of the study
Comments

QA phantoms can be recorded with a Device; multiple subjects (such as mice) can be recorded with a Group.

Control1..1
TypeReference(QICore Patient)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. ImagingStudy.encounter
Definition

The healthcare event (e.g. a patient and healthcare provider interaction) during which this ImagingStudy is made.

ShortEncounter with which this imaging study is associated
Comments

This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission test).

Control0..1
TypeReference(QICore Encounter)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. ImagingStudy.started
Definition

Date and time the study started.

Short(QI) When the study was started
Control0..1
TypedateTime
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Alternate NamesStudyDate, StudyTime
Example<br/><b>General</b>:2011-01-01T11:01:20+03:00
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. ImagingStudy.basedOn
Definition

A list of the diagnostic requests that resulted in this imaging study being performed.

Short(QI) Request fulfilled
Control0..*
TypeReference(QICore ServiceRequest, QICore CarePlan)
Is Modifierfalse
Summarytrue
Requirements

To support grouped procedures (one imaging study supporting multiple ordered procedures, e.g. chest/abdomen/pelvis CT).

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. ImagingStudy.referrer
Definition

The requesting/referring physician.

ShortReferring physician
Control0..1
TypeReference(QICore Practitioner, QICore PractitionerRole)
Is Modifierfalse
Must Supportfalse
Summarytrue
Alternate NamesReferringPhysiciansName
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. ImagingStudy.interpreter
Definition

Who read the study and interpreted the images or other content.

ShortWho interpreted images
Control0..*
TypeReference(QICore Practitioner, QICore PractitionerRole)
Is Modifierfalse
Must Supportfalse
Summarytrue
Alternate NamesName of Physician(s) Reading Study
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. ImagingStudy.endpoint
Definition

The network service providing access (e.g., query, view, or retrieval) for the study. See implementation notes for information about using DICOM endpoints. A study-level endpoint applies to each series in the study, unless overridden by a series-level endpoint with the same Endpoint.connectionType.

ShortStudy access endpoint
Comments

Typical endpoint types include DICOM WADO-RS, which is used to retrieve DICOM instances in native or rendered (e.g., JPG, PNG), formats using a RESTful API; DICOM WADO-URI, which can similarly retrieve native or rendered instances, except using an HTTP query-based approach; DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances; or IHE Invoke Image Display (IID), which provides standard invocation of an imaging web viewer.

Control0..*
TypeReference(Endpoint)
Is Modifierfalse
Summarytrue
Requirements

Access methods for viewing (e.g., IHE’s IID profile) or retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the study or the study’s series or instances. The study-level baseLocation applies to each series in the study, unless overridden in series by a series-level baseLocation of the same type.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. ImagingStudy.numberOfSeries
Definition

Number of Series in the Study. This value given may be larger than the number of series elements this Resource contains due to resource availability, security, or other factors. This element should be present if any series elements are present.

ShortNumber of Study Related Series
Control0..1
TypeunsignedInt
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Alternate NamesNumberOfStudyRelatedSeries
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. ImagingStudy.numberOfInstances
Definition

Number of SOP Instances in Study. This value given may be larger than the number of instance elements this resource contains due to resource availability, security, or other factors. This element should be present if any instance elements are present.

ShortNumber of Study Related Instances
Control0..1
TypeunsignedInt
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Alternate NamesNumberOfStudyRelatedInstances
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. ImagingStudy.procedureReference
Definition

The procedure which this ImagingStudy was part of.

Short(QI) The performed Procedure reference
Control0..1
TypeReference(QICore Procedure)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. ImagingStudy.procedureCode
Definition

The code for the performed procedure type.

ShortThe performed procedure code
Control0..*
BindingUnless not suitable, these codes SHALL be taken from http://www.rsna.org/RadLex_Playbook.aspx
(extensible to http://www.rsna.org/RadLex_Playbook.aspx)

The performed procedure type.

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Alternate NamesProcedureCodeSequence
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
46. ImagingStudy.location
Definition

The principal physical location where the ImagingStudy was performed.

ShortWhere ImagingStudy occurred
Control0..1
TypeReference(QICore Location)
Is Modifierfalse
Summarytrue
Requirements

Ties the event to where the records are likely kept and provides context around the event occurrence (e.g. if it occurred inside or outside a dedicated healthcare setting).

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
48. ImagingStudy.reasonCode
Definition

Description of clinical condition indicating why the ImagingStudy was requested.

ShortWhy the study was requested
Control0..*
BindingFor example codes, see ProcedureReasonCodes
(example to http://hl7.org/fhir/ValueSet/procedure-reason)

The reason for the study.

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. ImagingStudy.reasonReference
Definition

Indicates another resource whose existence justifies this Study.

ShortWhy was study performed
Control0..*
TypeReference(QICore Condition Problems Health Concerns, QICore Simple Observation, Media, QICore DiagnosticReport Profile for Report and Note Exchange, DocumentReference)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
52. ImagingStudy.note
Definition

Per the recommended DICOM mapping, this element is derived from the Study Description attribute (0008,1030). Observations or findings about the imaging study should be recorded in another resource, e.g. Observation, and not in this element.

ShortUser-defined comments
Control0..*
TypeAnnotation
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
54. ImagingStudy.description
Definition

The Imaging Manager description of the study. Institution-generated description or classification of the Study (component) performed.

ShortInstitution-generated description
Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Alternate NamesStudyDescription
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
56. ImagingStudy.series
Definition

Each study has one or more series of images or other content.

ShortEach study has one or more series of instances
Control0..*
TypeBackboneElement
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
58. ImagingStudy.series.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
60. ImagingStudy.series.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
62. ImagingStudy.series.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
64. ImagingStudy.series.uid
Definition

The DICOM Series Instance UID for the series.

ShortDICOM Series Instance UID for the series
Comments

See DICOM PS3.3 C.7.3.

Control1..1
Typeid
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

DICOM Series Instance UID.

Alternate NamesSeriesInstanceUID
Example<br/><b>General</b>:2.16.124.113543.6003.2588828330.45298.17418.2723805630
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
66. ImagingStudy.series.number
Definition

The numeric identifier of this series in the study.

ShortNumeric identifier of this series
Control0..1
TypeunsignedInt
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Alternate NamesSeriesNumber
Example<br/><b>General</b>:3
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
68. ImagingStudy.series.modality
Definition

The modality of this series sequence.

ShortThe modality of the instances in the series
Control1..1
BindingUnless not suitable, these codes SHALL be taken from AcquisitionModality
(extensible to http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html)

Type of acquired data in the instance.

TypeCoding
Is Modifierfalse
Summarytrue
Alternate NamesModality
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
70. ImagingStudy.series.description
Definition

A description of the series.

ShortA short human readable summary of the series
Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Alternate NamesSeriesDescription
Example<br/><b>General</b>:CT Surview 180
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
72. ImagingStudy.series.numberOfInstances
Definition

Number of SOP Instances in the Study. The value given may be larger than the number of instance elements this resource contains due to resource availability, security, or other factors. This element should be present if any instance elements are present.

ShortNumber of Series Related Instances
Control0..1
TypeunsignedInt
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Alternate NamesNumberOfSeriesRelatedInstances
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
74. ImagingStudy.series.endpoint
Definition

The network service providing access (e.g., query, view, or retrieval) for this series. See implementation notes for information about using DICOM endpoints. A series-level endpoint, if present, has precedence over a study-level endpoint with the same Endpoint.connectionType.

ShortSeries access endpoint
Comments

Typical endpoint types include DICOM WADO-RS, which is used to retrieve DICOM instances in native or rendered (e.g., JPG, PNG) formats using a RESTful API; DICOM WADO-URI, which can similarly retrieve native or rendered instances, except using an HTTP query-based approach; and DICOM QIDO-RS, which allows RESTful query for DICOM information without retrieving the actual instances.

Control0..*
TypeReference(Endpoint)
Is Modifierfalse
Summarytrue
Requirements

Access methods for retrieving (e.g., DICOM’s WADO-URI and WADO-RS) the series or the series’ instances. A baseLocation specified at the series level has precedence over a baseLocation of the same type specified at the study level.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
76. ImagingStudy.series.bodySite
Definition

The anatomic structures examined. See DICOM Part 16 Annex L (http://dicom.nema.org/medical/dicom/current/output/chtml/part16/chapter_L.html) for DICOM to SNOMED-CT mappings. The bodySite may indicate the laterality of body part imaged; if so, it shall be consistent with any content of ImagingStudy.series.laterality.

ShortBody part examined
Control0..1
BindingFor example codes, see SNOMEDCTBodyStructures
(example to http://hl7.org/fhir/ValueSet/body-site)

Codes describing anatomical locations. May include laterality.

TypeCoding
Is Modifierfalse
Summarytrue
Alternate NamesBodyPartExamined
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
78. ImagingStudy.series.laterality
Definition

The laterality of the (possibly paired) anatomic structures examined. E.g., the left knee, both lungs, or unpaired abdomen. If present, shall be consistent with any laterality information indicated in ImagingStudy.series.bodySite.

ShortBody part laterality
Control0..1
BindingFor example codes, see Laterality
(example to http://hl7.org/fhir/ValueSet/bodysite-laterality)

Codes describing body site laterality (left, right, etc.).

TypeCoding
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
80. ImagingStudy.series.specimen
Definition

The specimen imaged, e.g., for whole slide imaging of a biopsy.

ShortSpecimen imaged
Control0..*
TypeReference(Specimen)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
82. ImagingStudy.series.started
Definition

The date and time the series was started.

ShortWhen the series started
Control0..1
TypedateTime
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
84. ImagingStudy.series.performer
Definition

Indicates who or what performed the series and how they were involved.

ShortWho performed the series
Comments

If the person who performed the series is not known, their Organization may be recorded. A patient, or related person, may be the performer, e.g. for patient-captured images.

Control0..*
TypeBackboneElement
Is Modifierfalse
Summarytrue
Requirements

The performer is recorded at the series level, since each series in a study may be performed by a different performer, at different times, and using different devices. A series may be performed by multiple performers.

Alternate NamesPerformingPhysicianName, OperatorName
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
86. ImagingStudy.series.performer.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
88. ImagingStudy.series.performer.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
90. ImagingStudy.series.performer.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
92. ImagingStudy.series.performer.function
Definition

Distinguishes the type of involvement of the performer in the series.

ShortType of performance
Control0..1
BindingUnless not suitable, these codes SHALL be taken from ImagingStudySeriesPerformerFunction
(extensible to http://hl7.org/fhir/ValueSet/series-performer-function)

The type of involvement of the performer.

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Requirements

Allows disambiguation of the types of involvement of different performers.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
94. ImagingStudy.series.performer.actor
Definition

Indicates who or what performed the series.

ShortWho performed the series
Control1..1
TypeReference(QICore Practitioner, QICore PractitionerRole, QICore Organization, QICore CareTeam, QICore Patient, QICore Device, US Core Implantable Device Profile, QICore RelatedPerson)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
96. ImagingStudy.series.instance
Definition

A single SOP instance within the series, e.g. an image, or presentation state.

ShortA single SOP instance from the series
Control0..*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
98. ImagingStudy.series.instance.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
100. ImagingStudy.series.instance.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
102. ImagingStudy.series.instance.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
104. ImagingStudy.series.instance.uid
Definition

The DICOM SOP Instance UID for this image or other DICOM content.

ShortDICOM SOP Instance UID
Comments

See DICOM PS3.3 C.12.1.

Control1..1
Typeid
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Requirements

DICOM SOP Instance UID.

Alternate NamesSOPInstanceUID
Example<br/><b>General</b>:2.16.124.113543.6003.189642796.63084.16748.2599092903
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
106. ImagingStudy.series.instance.sopClass
Definition

DICOM instance type.

ShortDICOM class type
Control1..1
BindingUnless not suitable, these codes SHALL be taken from http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1
(extensible to http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1)

The sopClass for the instance.

TypeCoding
Is Modifierfalse
Summaryfalse
Alternate NamesSOPClassUID
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
108. ImagingStudy.series.instance.number
Definition

The number of instance in the series.

ShortThe number of this instance in the series
Control0..1
TypeunsignedInt
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Alternate NamesInstanceNumber
Example<br/><b>General</b>:1
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
110. ImagingStudy.series.instance.title
Definition

The description of the instance.

ShortDescription of instance
Comments

Particularly for post-acquisition analytic objects, such as SR, presentation states, value mapping, etc.

Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))